From the Guidelines
Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties, resulting from abnormal pain processing in the central nervous system, as described in the most recent study by 1.
Key Characteristics of Fibromyalgia
- Widespread musculoskeletal pain
- Fatigue
- Sleep disturbances
- Cognitive difficulties
- Abnormal pain processing in the central nervous system
Diagnosis and Management
According to the study by 1, the management of fibromyalgia should aim at improving health-related quality of life, balancing benefit and risk of treatment, and often requires a multidisciplinary approach with a combination of non-pharmacological and pharmacological treatment modalities.
Treatment Options
- First-line medications: duloxetine (Cymbalta) 30-60mg daily, milnacipran (Savella) 50mg twice daily, or pregabalin (Lyrica) 150-450mg daily divided into multiple doses, as recommended by 1
- Non-pharmacological management: aerobic and strengthening exercise, cognitive behavioral therapies, multicomponent therapies, defined physical therapies, and meditative movement therapies, as suggested by 1
- Lifestyle changes: maintaining a consistent sleep schedule, avoiding caffeine before bedtime, and regular moderate exercise, as mentioned in 1
Importance of Individualized Treatment Plan
Patients should work with healthcare providers to develop an individualized treatment plan, as fibromyalgia symptoms vary widely between individuals, as emphasized by 1.
Quality of Life
Proper management of fibromyalgia is essential for improving quality of life, as highlighted by 1.
From the Research
Definition and Characteristics of Fibromyalgia
- Fibromyalgia is a common chronic pain disorder with unclear etiology 2
- It is characterized by disordered processing of painful stimuli, diffuse chronic pain, poor sleep, fatigue, cognitive dysfunction, and mood disturbances 3
- Fibromyalgia is diagnosed more frequently in women and occurs globally, affecting 2% of people in the United States 3
Symptoms and Comorbidities
- Patients with fibromyalgia often experience symptoms such as fatigue, sleep deprivation, mental fog, mood swings, and headaches 4
- Comorbid conditions, such as functional somatic syndromes, psychiatric diagnoses, and rheumatologic conditions, may be present 3
- Back pain, hypertension, headache, depression, and sleep disorder are common comorbidities in fibromyalgia patients 2
Diagnosis and Treatment
- The Fibromyalgia Rapid Screening Tool is a helpful screening method for patients with diffuse chronic pain 3
- The American College of Rheumatology criteria or the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy diagnostic criteria can diagnose fibromyalgia 3
- A multidisciplinary approach that incorporates nonpharmacologic therapies and medications, such as duloxetine, milnacipran, pregabalin, and amitriptyline, is most effective for managing fibromyalgia symptoms 3, 5
- Aerobic exercise, such as walking and swimming, can also play a role in reducing pain in fibromyalgia patients 6